09 Jun

DIABETES AND EXERCISE THERAPY: EXERCISE & INSULIN AND EVALUATION OF THE PATIENT BEFORE EXERCISE EXERCISE & INSULIN EXERCISE CAUSES

1. Increase in sensitivity of muscles to insulin. Major site – Skeletal muscles, followed by adipose tissue to a lesser extent.
2. Increases in insulin action (could be mediated by several factors)-
i) Increase in insulin binding receptors sites in the muscles and increase in the number of receptors.
ii) Increase in cytoplasmic and mitochondrial activity.
iii) Increase in muscles, capillary density.
iv) Increase in GLUT -4 protein &mRNA.
RESPONSE TO EXERCISE DEPENDS UPON
Diabetic status of patient.
Blood glucose level.
Availability of insulin.
State of hydration.
EVALUATION OF THE PATIENT BEFORE EXERCISE
Before beginning an exercise program, the examination of diabetes patients should include careful screen for the presence of macrovascular and microvascular complications that may be worsened by the exercise.
A careful medical history and physical examination should focus on the symptoms and signs of disease affecting the heart, blood vessels, eyes, kidneys, nervous system and diabetic foot etc.
Before an exercise therapy is initiated a fair control of diabetes is to be ensured.
*37\329\8*
Comments Off  |  Add Comment
10 Feb

KEY POINTS: CONSENSUS FOR INTENSIVE MANAGEMENT OF LIPIDS AND LIPOPROTEINS IN TYPE 2 DIABETES

The ADA and the NCEP (ATP III) now agree in recommending intensive treatment for lipids/lipoproteins in type 2 diabetes.
LDL-C is the primary target of therapy. Optimal levels of LDL-C are < 100 mg/dl.
Triglycerides and HDL-C are secondary targets.
Optimal triglyceride level is < 150 mg/dl.
Optimal HDL-C levels are > 45 mg/dl for men and > 55 mg/dl for women.
The first step is total lifestyle change (TLC).
TLC includes a desirable body weight, exercise program, and meal plan with saturated fat < 7% of calories, cholesterol < 200 mg/day, and monounsaturated fat up to 20% of calories. TLC recommends 25-35% of calories as fat, 50-60% as carbohydrate, 15% as protein, and 20-30 gm of fiber daily. The non-HDL-C (cholesterol minus HDL-C) target is < 130 mg/dl. This goal should be used if high plasma triglyceride levels (200-499 mg/dl) are present after LDL-C is < 100 mg/dl.
Fibrate or nicotinic acid therapy is recommended if the non-HDL-C level is > 130 mg/dl.
*171\257\8*

KEY POINTS: CONSENSUS FOR INTENSIVE MANAGEMENT OF LIPIDS AND LIPOPROTEINS IN TYPE 2 DIABETESThe ADA and the NCEP (ATP III) now agree in recommending intensive treatment for lipids/lipoproteins in type 2 diabetes.LDL-C is the primary target of therapy. Optimal levels of LDL-C are < 100 mg/dl.Triglycerides and HDL-C are secondary targets.Optimal triglyceride level is < 150 mg/dl.Optimal HDL-C levels are > 45 mg/dl for men and > 55 mg/dl for women.The first step is total lifestyle change (TLC).TLC includes a desirable body weight, exercise program, and meal plan with saturated fat < 7% of calories, cholesterol < 200 mg/day, and monounsaturated fat up to 20% of calories. TLC recommends 25-35% of calories as fat, 50-60% as carbohydrate, 15% as protein, and 20-30 gm of fiber daily. The non-HDL-C (cholesterol minus HDL-C) target is < 130 mg/dl. This goal should be used if high plasma triglyceride levels (200-499 mg/dl) are present after LDL-C is < 100 mg/dl.Fibrate or nicotinic acid therapy is recommended if the non-HDL-C level is > 130 mg/dl.*171\257\8*

Comments (0)  |  Add Comment